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Self-help: What future role in health care for low and middle-income countries?

Nayar, KR ; Kyobutungi, Catherine ; Razum, Oliver

In: International Journal for Equity in Health, 3 (2004), Nr. 1. pp. 1-10. ISSN 1475-9276

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In the debate on 'Third options' for health care delivery in low- and middle-income countries it is proposed that self-help should play a larger role. Self-help is expected to contribute towards improving population health outcomes and reducing government health care expenditure. We review scope and limitations of self-help groups in Europe and South Asia and assess their potential role in health care within the context of health sector reform. Self-help groups are voluntary unions of peers, formed for mutual assistance in accomplishing a health-related purpose. In Europe, self-help groups developed out of dissatisfaction with a de-personalised health care system. They successfully complement existing social and health services but cannot be instrumentalized to improve health outcomes while reducing health expenditure. In South Asia, with its hierarchical society, instrumental approaches towards self-help prevail in Non-governmental Organizations and government. The utility of this approach is limited as self-help groups are unlikely to be sustainable and effective when steered from outside. Self-help groups are typical for individualistic societies with developed health care systems – they are less suitable for hierarchical societies with unmet demand for regulated health care. We conclude that self-help groups can help to achieve some degree of synergy between health care providers and users but cannot be prescribed to partially replace government health services in low-income countries, thereby reducing health care expenditure and ensuring equity in health care.

Item Type: Article
Journal or Publication Title: International Journal for Equity in Health
Volume: 3
Number: 1
Publisher: BioMed Central
Place of Publication: London
Date Deposited: 15 Feb 2017 14:46
Date: 2004
ISSN: 1475-9276
Page Range: pp. 1-10
Faculties / Institutes: Medizinische Fakultät Heidelberg > Department for Infectiology
Medizinische Fakultät Heidelberg > Institut für Public Health (IPH)
Subjects: 300 Social sciences
610 Medical sciences Medicine
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